Uveitis: symptoms and treatment

Uveitis an eye is a medical term used to describe the progression of the inflammatory process in various parts of the choroid of the eye (choroid, ciliary body, iris). Medical statistics are such that in 25% of clinical cases this particular ailment causes a decrease in visual function or even blindness. On average, uveitis is diagnosed in one person out of 3000 (data for 12 months). It is worth noting that in the representatives of the strong half of humanity pathology is found several times more often than in women.



Inflammation of the uveal tract in the ophthalmic sphere occurs in 30-57% of cases of the total number of inflammatory lesions of the visual apparatus. This prevalence of the pathological process is explained by the peculiarities of the anatomical structure of the uveal tracts. So, they have a very branched vasculature, and the blood flow in them is somewhat slower. This is the reason that infectious agents may be delayed in the choroid. Normally, they do not pose a threat to human health, but under the influence of various adverse exogenous or endogenous factors can trigger the progression of inflammation. It is important that when the first symptoms of uveitis appear, seek medical help immediately. Diagnosis and treatment of this painful process is handled by an ophthalmologist.

Etiology

Many factors can provoke inflammation of the uveal tract: allergic reactions, syndrome and autoimmune diseases, traumas of the visual apparatus of various severity, metabolic and hormonal disturbances, pathological activity of infectious agents.

In 43% of clinical cases, the pathogenic activity of microorganisms became the «trigger mechanism» for the development of this disease. Most often, uveitis develops due to penetration into the uveal tract of the following infectious agents:


  • Streptococci
  • Koch’s wand
  • toxoplasm;
  • cytomegalovirus
  • fungi
  • Herpesvirus
  • pale treponema.

Allergic uveitis progresses because of the increased sensitivity of the body to certain substances. It develops against the background of hay fever, food or drug allergies, and it can not be ruled out after the introduction of various serums or vaccines into the body. Only in this case we are already talking about whey uveitis.

Also, the inflammation of the uveal tract can progress against a background of autoimmune, syndromic or systemic pathologies (the etiological relationship between pathologies has already been proven). Most often, the disease is diagnosed with:


  1. ulcerative colitis
  2. spondylarthrosis;
  3. glomerulonephritis
  4. rheumatoid arthritis (in this case, rheumatoid uveitis develops)
  5. Multiple sclerosis
  6. autoimmune thyroiditis
  7. Reiter’s syndrome;
  8. psoriasis
  9. sarcoidosis.

The development of the inflammation of the uveal tract can be facilitated by various failures of the hormonal background, metabolic disorders, the pathology of the hematopoiesis system, as well as the ailments of the visual apparatus (scleritis, blepharitis, conjunctivitis).

Species

The classification of the inflammation of the uveal tract is based on the location of the inflammatory process, the nature of its course, the etiology, and the characteristics of the clinical course.

Depending on the localization of inflammation:


  • anterior uveitis. This form of ailment is diagnosed in patients most often (from 40 to 70% of cases). In the medical literature, anterior uveitis is divided into iritis and cyclites. In this case, the inflammation is localized either in the ciliary body, or in the iris itself and the tissues located in close proximity to it. If the inflammation affects the ciliated body, then cyclilite progresses, and if the iris is irritated. Often there is a lesion of two specified elements of the visual apparatus simultaneously. In this case, the pathology is called iridocyclitis;
  • peripheral uveitis or intermediate. This is the rarest form of this ailment. Inflammation in this case affects the zone immediately behind the ciliary body;
  • Posterior uveitis. Also a form that is rarely diagnosed. A characteristic feature — inflammation affects the choroid of the eye. In severe cases, can go to the optic nerve and reticular membrane. Choroiditis refers to an ailment in which inflammation is localized in the posterior region of the vascular layer. If the retina involves the process, then chorioretinitis develops, and if the entire tract is panovenite.

Depending on the nature of the inflammation, they are:


  1. serous uveitis;
  2. fibrinous-lamellar;
  3. Purulent;
  4. hemorrhagic
  5. Mixed.

Depending on the etiology:


  • Primary uveitis. Progresses against the background of already existing pathologies in the body;
  • secondary. Develops in the pathology of the visual apparatus.

Depending on the nature of the inflammation:


  1. sharp. Usually occurs for the first time. It is characterized by a bright manifestation of symptoms — the eyeball is hyperemic, the visual function is reduced, and painful sensations appear in the eye. Acute inflammation of the uveal tract develops due to the pathogenic activity of infectious agents;
  2. Chronic. More often, such uveitis are autoimmune, or they manifest themselves as a result of an incompletely treated acute form of a disease. With chronic uveitis, there is a change in periods of exacerbation and subsiding of symptoms
  3. Sluggish uveitis. This term is usually applied to acute inflammatory process. In the case of this form, there are slight symptoms that appear in a person for 2 months.

Symptoms

Symptoms of anterior uveitis:





  • hyperemia sclera
  • pupil narrowing;
  • a pronounced reaction to light stimuli
  • pain in the visual apparatus
  • lacrimation
  • Decreased visual function
  • increase in intraocular pressure.

Symptoms of peripheral form:


  1. decreased vision;
  2. Symmetrical eye damage is observed
  3. flashing «flies» before your eyes.

In the case of progression of posterior uveitis, the first symptoms appear late. A person has:


  • Decreased visual function
  • blurring of vision. It may seem to him that before his eyes a translucent veil;
  • distortion of the outlines of certain objects
  • points of different sizes float before your eyes.

Complications

If you do not pay attention to the symptoms of the pathology in time and do not complete the treatment of uveitis, the following dangerous complications may develop:


  1. Cataract
  2. secondary glaucoma;
  3. damage to the optic nerve
  4. Infiltration of the lens
  5. formation of synechia
  6. blindness.

Diagnostics

The standard plan for diagnosing this pathology includes the following manipulations and procedures:


  • visual inspection of the eye;
  • visual acuity assessment
  • Tonometry
  • the pupil response test
  • Gonioscopy
  • ophthalmoscopy;
  • Ultrasound;
  • Tomography of certain elements of the visual apparatus
  • angiography;
  • rheophthalmography

Healing measures

Treatment of uveitis is carried out by two methods — conservative and operative. As a rule, first doctors resort to a medicamentous treatment option for pathology. The patient is prescribed such pharmaceutical preparations:


  1. antihistamines
  2. mydriatica
  3. steroids (locally);
  4. eye drops containing substances to reduce intraocular pressure
  5. antimicrobial and antiviral.

In severe clinical cases, doctors can decide to conduct an operative intervention. The following operations are performed:


  • vitrectomy;



  • Evisceration of the eyeball.